The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

A RETROSPECTIVE REVIEW OF VENTILATOR-ASSOCIATED PNEUMONIA OCCURING POST-IMPLEMENTATION OF THE VENTILATOR BUNDLE

R. Hase1, M. Westley2


Background: In 2002, we implemented a reliable process to ensure compliance with each ventilator bundle element and observed an 89% reduction in our ventilator-associated pneumonia (VAP). We document and review each VAP case upon diagnosis, as part of our quality and safety processes. This study retrospectively reviews data from all VAP cases since 2004.

Methods: Data was collated for each patient diagnosed with VAP and recorded on a Microsoft Excel spreadsheet for tracking, including multiple fields reflecting VAP risk factors, such as admitting diagnosis, co morbidities, days intubated, date VAP diagnosed, and VAP organism. In addition, we randomly selected 30 patients from all patients who received mechanical ventilation for at least three days during the same time period and tracked similar data, also including duration of intubation, comorbidities, and admitting diagnosis. Data was compared between the two populations; data was also compared case-to-case within the VAP population.

Results: There were no significant differences in the data we collected between the two populations. Within the VAP population, we noticed that the VAP diagnosis always occurred on or before intubation day 16 even when the total ventilated population included a significant number of patients with extended duration of mechanical ventilation. We also noted a cohort of early VAPs that were diagnosed between intubation day 3 and 8.

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